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Thursday, 11 October, 2001, 23:31 GMT 00:31 UK
Malaria drug could 'beat resistance'
Children are particularly vulnerble to malaria
Children are particularly vulnerble to malaria
Scientists believe they may have found a way to beat drug-resistant malaria in Africa.

The new combination of drugs, chlorproguanil-dapsone, has been shown to be effective in cases where the standard medication failed.

Malaria kills around a million people every year, many of them in Africa.

It kills more than Aids, tuberculosis, or diarrhoeal diseases such as cholera.

Africa is in desperate need of an effective and affordable alternative to [the existing treatment] to prevent escalating malaria morbidity and mortality

Research team
For 40 years a drug called chloroquine was used as an effective treatment for malaria.

But in the mid-80s, African malaria parasites became resistant to the drug, meaning it would no longer treat malaria.

In Tanzania, Malawi, South Africa, and Kenya, front-line treatment has been, or is being changed to, a combination of antimalarial drugs called pyrimethamine-sulfadoxine.

But over the last 10 years, there have been increasing reports of malaria which is resistant to this treatment.

Any alternative has to be cheap, so the countries which need it can afford to buy it, rather than a "wonder drug" that no-one can pay for.

This latest study suggests chlorproguanil-dapsone could be the solution.

Treatment options

Dr Theonest Mutabingwa and colleagues from the National Institute for Medical Research in Tanzania studied 360 children under five in Muheza, northeastern Tanzania.

All had falciparum malaria, the most severe form of the disease.

The children were first given standard pyrimethamine-sulfadoxine treatment.

Ninety-two children's whose blood was not clear of malaria parasites seven days later, and who developed a second episode of malaria, were given either a repeat dose of the same treatment or the new combination, chlorproguanil-dapsone.

Ninety-three per cent of those treated with the chlorproguanil-dapsone were cleared of parasites.

Of those children given pyrimethamine-sulfadoxine, only 39% of children were clear of malaria a week later.

And resistance to pyrimethamine-sulfadoxine increased after the retreatment.

Crucial proof

The researchers say their findings are crucial because of the growing problem of resistance to the pyrimethamine-sulfadoxine treatment.

Chlorproguanil-dapsone is currently being thought of as a second-line treatment.

But if pyrimethamine-sulfadoxine-resistant malaria increases, which the researchers warn it could do if widespread use continues, chlorproguanil-dapsone may have to be the first-line treatment in the future.

Work on a drug containing chlorproguanil-dapsone, and an artemisinine - a natural antimalarial - derivative is underway, but the scientists warn it will take time.

Writing in the Lancet, they say: "Africa is in desperate need of an effective and affordable alternative to pyrimethamine-sulfadoxine, to prevent escalating malaria morbidity and mortality."

David Warhurst, co-director of the Public Health Laboratory Service Malaria Reference Laboratory and professor of protozoan chemotherapy, said: "This treatment is of huge importance because malaria kills, especially in children and pregnant women.

But he warned how long the treatment would last before a form of malaria developed which was resistant to it was in "the lap of the Gods".

See also:

07 Jun 01 | Health
Cattle used to fight malaria
23 May 01 | Health
Africa to get cheap malaria drug
26 Jul 99 | Medical notes
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